Treatment of Laryngeal Cancer

It must be emphasized that each case of laryngeal cancer is unique and treatment cannot be considered standardized. Many factors influence the type or types of treatment proposed for an individual diagnosed with laryngeal cancer. There also are many situations in which different treatment options are available; the patient and the physician must then together decide which option is best for that patient.

These descriptions are deliberately brief and are meant to provide only basic information. Please make sure to read the disclaimer regarding information presented in this web site.

A very small laryngeal cancer (what would be called a T1 tumor on the staging system) can be treated either with radiation therapy or with surgery. Radiation therapy is a daily procedure which lasts about 15-30 minutes each day, five days a week, for about six weeks. Surgery is done most often through the mouth and involves removing the portion of the larynx that contains the tumor.

A larger tumor, involving more than one portion of the larynx, can also be treated with radiation therapy or with surgery. Since the tumor is larger, the treatments must usually be more extensive. The radiation therapy is done in a similar fashion, but a larger part of the larynx is treated. If surgery is chosen, it involves removing a larger portion of the larynx. This operation is called a "partial laryngectomy" and is almost always done through an incision in the neck. Post operatively a temporary tracheotomy (breathing hole in the neck) must often be used.

If a large portion of the larynx is involved with cancer, even more aggressive treatment must be used. The more aggressive surgical treatment is removal of the entire larynx, a procedure called a total laryngectomy. In order to complete this operation the windpipe must be brought out to the neck to form a permanent opening called a stoma. Since the vocal cords are removed in this operation, the patient must learn a new manner of speaking. 

In some cases a combination of chemotherapy and radiation therapy can be used at first instead of surgery. In this case the patient is carefully examined after two treatments with chemotherapy and continues with additional chemotherapy and radiation therapy if the tumor has shrunken. If the tumor has not become smaller, a total laryngectomy must be done.

In addition to the larynx, the neck must also be treated since this cancer has a tendency to spread to lymph nodes in the neck. The neck can also be treated with either radiation or surgery. A separate sheet describes the surgical procedure,which is called neck dissection.

Close follow-up is extremely important after any treatment for head and neck cancer since there is a risk that the tumor can recur. This risk is greater if the patient continues to smoke, so smoking cessation is extremely important. Typically the otolaryngologist will want to do exams in the office about once a month for a year, and then gradually decrease the frequency of the visits.

It is important to remember that these descriptions are deliberately brief and are meant to provide only basic information. There are many other implications to these treatments which can only be discussed on an individual basis with your doctor.